Titrating lovaza from 4 to 8 to 12 grams/day in patients with primary hypertriglyceridemia who had triglyceride levels >500?mg/dl despite conventional triglyceride lowering therapy

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• 作者：Charles J Glueck (1)
  Naseer Khan (1)
  Muhammad Riaz (1)
  Jagjit Padda (1)
  Zia Khan (1)
  Ping Wang (1)
  
• 关键词：Triglyceride ; Lovaza ; Triglyceride ; lowering therapy ; Severe primary hypertriglyceridemia
• 刊名：Lipids in Health and Disease
• 出版年：2012
• 出版时间：December 2012
• 年：2012
• 卷：11
• 期：1
• 全文大小：288KB
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• 作者单位：Charles J Glueck (1)
  Naseer Khan (1)
  Muhammad Riaz (1)
  Jagjit Padda (1)
  Zia Khan (1)
  Ping Wang (1)
  
  1. Cholesterol Center, Jewish Hospital of Cincinnati, UC Health Building, 3200 Burnet Avenue, Cincinnati, OH 45229, USA
  

文摘

Background Omega-3 fatty acids are important in treatment of severe primary hypertriglyceridemia (HTG). In 15 patients with severe primary HTG (TG >500?mg/dl despite conventional TG lowering therapy), we assessed efficacy-safety of sequential monthly treatment with Lovaza, 4 to 8 to 12?g/day. Methods With TG >500?mg/dl despite Type V diet, hyperinsulinemia and diabetes control, and fibric acids, Lovaza (4?g/d) was added for 1?month, and if TG remained >500?mg/dl, increased to 8?g/d for 1?month, and then to 12?g/d for 1?month, and subsequently reduced to 4?g/day for 4?months. Results Primary HTG, median TG 884?mg/dl, 14 men, 1 woman, all white, age 50 ± 7?years, 12 non-diabetic, 3 with stable diabetes control. Weight and diet held stable throughout. In 5 patients, after 1, 2, and 3?months on 4?g/day, TG fell <500, mean 1390 to 234 (?3%, p<.0001), to 135 (?0%, p<.0001), and 158?mg/dl (?9%, p<.0001), with a negative TG slope, p=.0013. Non-HDLC fell from 320 to 177 (?5%, p=.001), to 152 (?3%, p=.0002), and to 163 (?9%, p=.0004), with a negative slope, p=.01. In 10 patients, with Lovaza increased from 4 to 8 to 12?g, 3 failed to respond. In 7 of these 10 patients, TG fell 37% from 1075 to 672 on 4?g (p=.006), to 577 on 8?g (?6%, p=.0009), and to 428?mg/dl (?0%, p<.0001) on 12?g/day, with a negative TG slope, p=.0018. TG on 12?g/day was lower than on 8?g/day, p =.03. Non-HDLC fell from 245 to 217?mg/dl (?1%) on 4?g/day, to 203 (?7%, p=.01) on 8?g/day, and to 192 (?2%, p=.003) on 12?g/day, with a negative slope, p=.016. Compared to pre-Lovaza baseline, no abnormal measures developed in safety tests. The 4, 8, and 12?g/d Lovaza doses were well tolerated. Conclusion Titration of Lovaza from 4 to 8 to 12?g/d safely offers an effective way to lower TG beyond conventional 4?g therapy.